Is psychotherapy “just talking?” Part I.

“How is talking about my problems going to help? The problem is still there whether I talk about it or not!” “Why would I see a psychologist – it’s just talking. It’s not going to do anything for me.” “I don’t need therapy – I need a solution to my problems!” These questions can come up for people when they are seeing a psychotherapist for the first time. The person may find themselves in a clinic or a hospital for treatment of a problem they did not expect to see a psychologist for: chronic pain, sleep problems, or health problems like heart disease. Surprisingly (to some), even issues that have a very clear psychological piece, such as depression and anxiety, can be tethered securely to the expectation that this is a strictly medical problem, to be treated only with medication, rather than an emotional-psychological problem that can be successfully treated with psychotherapy.

Not surprisingly (also to some), anxiety, depression, persistent pain – all of these conditions can be improved significantly with…just talking! Wait, but is psychotherapy “just talking,” truly? In this blog I attempt to shed some light on these questions as I explore what happens in a psychotherapy session. What’s “under the hood” when a client and a psychologist are engaged in a therapeutic encounter? I am going to talk about some of the cognitive processes – what happens in the mind – when therapy unfolds. When I say ‘cognitive processes,” examples of what I mean are: integration of new information (knowledge formation); formation of expectation and goals; analysis of how behaviour aligns with the person’s goals (or, sometimes, when we stand in our own way, how our own behaviour can actually contradict our very own goals and values). What is meant by ‘cognitive processes’ will, hopefully, become clearer in this discussion.

I should also mention that there is exciting new area of research on neurobiological processes that occur in the process of therapy, but that is a whole other topic for an entirely other future blog entry.

Firstly, is psychotherapy “just talking?” After devoting eleven years to the study of human mind and behaviour and, in the later years, the study of psychotherapy specifically, I am landing on a firm “Nope” on this one. Psychotherapy is definitely not “just talking.” Before I address this on a psychology-specific level, let’s think of it on just a logical level, comparing it to other types of “talking” you might do with various people. For instance, you might play sports, dance, or train for some incredible feat like Tough Mudder and sustain a physical injury in the course of your training. You’ll probably talk, at least a little, to your best friend, partner, parents, or co-workers about the injury. You might also book an appointment with a medical doctor or a physiotherapist if the symptoms do not seem to be improving on their own. When you meet the physician or the physiotherapist, you will talk to them about your injury. Are you “just talking” then? After all, especially if you’ve already talked to your significant others about it, why go see this other person and even pay money to talk more about something you probably don’t want to talk about – how crappy and disappointing it can be to have an injury that’s not getting better?

Here Captain Logic would swiftly descend from the baby-blue sky and remind us: “Ah, but you are talking to a professional with expertise in these injuries and in-depth knowledge of human physiology and biology! They have years of education and practical experience helping people recover from injuries just like this, helping people to understand their physical bodies better so that they can do the appropriate things to help their own recovery! You are likely not “just talking” to your physician, you are providing information about yourself, learning information from your doctor, perhaps even working together to analyse what the problem is, and, ideally, planning next steps.”***

***This, of course, is an idealized version of what happens in a doctor’s office, but let’s just go with this general template since this is a hypothetical example of how Captain Logic works, okay? Awesome.

Moving on, then. When problems come up that are emotional in nature or have a psychological component, you might want to do the same thing – discuss it with a professional who has years of specific training and experience dealing with the exactly kind of difficulty that you are experiencing, a professional with a deep understanding of the human mind. Psychologists receive incredibly in-depth training on understanding human emotions, behaviours, thoughts, and relationships. The psychology profession has very high standards for providing treatment, meaning that when you see a registered psychologist, there is a huge baggage of expertise they will bring to the session with you.

Okay, Captain Logic aside, what does a psychologist do in psychotherapy? They are not like a medical doctor, after all. For instance, psychologists do not prescribe medication.

Good question. In Part II of this blog, we’ll get to the tofu (or meat) and potatoes of what processes are going on as psychotherapy unfolds.